Wednesday, June 29, 2011

Third-year medical student as point of patient care

As I was presenting a patient to my resident, the nurse interrupted me to tell me that my patient's blood pressure was elevated. She then asked me what I wanted to do about it. She asked me. I was taken aback for a moment, looked at my resident, but he was looking right back at me waiting for an answer.

My answer: I thought that the high blood pressure was likely caused by pain and that we should just monitor her vitals and administer her regular blood pressure medications since her blood pressure had previously been well-controlled.

I looked back at my resident. Did I get the "correct" answer? He disagreed and recommended giving an extra medication to lower the patient's blood pressure immediately. Even though my recommendation didn't match my resident's, he did agree that my reasoning and recommendation were also valid.

What felt good, though, was that the nurse came to me with a question about my patient, not to my intern or resident. First, it tells me that I'm doing something right if the nurse perceived me as my patient's primary point of care. Second, it made me look good in front of my resident. I thanked the nurse for that, later.

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